CMSC Updates Proposed 2017 Guidelines for Standardized Brain and Spinal Cord MRI Protocols
The Consortium of Multiple Sclerosis Centers (CMSC), in collaboration with the CMSC Task Force for a Standardized MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-up of Multiple Sclerosis (MS) updated the standardized MRI protocol useful when evaluating people suspected of having MS and for following individuals undergoing treatment for MS. These guidelines evolved from a meeting of the task force comprised of an international group of neurologists, radiologists and imaging scientists with expertise in MS. The group met in Newark, NJ, January 11-12, 2017 to revise and update the guidelines and indications for standardized brain and spinal cord MRI for MS including attention to the use of gadolinium, based on new data, survey results and expert opinion. These proposed recommendations are currently under review in preparation for a manuscript.
Clinical guidelines from the CMSC for the diagnosis and follow-up of MS had previously recommended the routine use of gadolinium based contrast agents (GBCA) in brain magnetic resonance imaging (MRI) for the diagnosis and follow-up of patients with MS. Soon after the publication of these recommendations in 2015, the CMSC became aware of the concerns regarding gadolinium deposition in the brain and the recommendations of the FDA to limit GBCA use to appropriate clinical circumstances.
The proposed 2017 revised guidelines that are posted on the CMSC website, now state, "While there is no know central nervous system toxicity, these agents should be used judiciously, recognizing that gadolinium continues to play an invaluable role in specific circumstances related to the diagnosis and follow-up of individuals with MS." This is an important change compared to the earlier recommendation. Other key changes to the MRI protocols since the 2009 include emphasis on 3-D sequences for brain MRI, Progressive Multifocal Leukoencephalopathy (PML) specific monitoring protocol, and optional orbit MRI protocol for severe optic neuritis.
Key changes to the clinical guidelines since 2009 includes more specific timing of brain MRI for monitoring patients on disease modifying therapy, specific timing for brain MRI for PML surveillance, updated evidence on the value of MRI changes in determining treatment effectiveness, and inclusion of radiologic isolated syndrome.
"The CMSC's goal in posting these guidelines is to standardize the MRI protocol and make these recommendations a useful guideline for neurologists, neuroradiologists, and related healthcare professionals during initial evaluations and during follow-up of patients with MS, and ultimately provide optimum care for those individuals dealing with this unpredictable disease," said June Halper, Chief Executive Officer of the CMSC.
The 2017 Proposed Revised Guidelines of the CMSC MRI Protocol for the Diagnosis and Follow-up of MS can be found under the "Resources" section on the CMSC website at www.mscare.org. Please note: The 2017 guidelines are subject to change since the CMSC Task Force is in the process of review. The 2015 MRI Guidelines from the CMSC Task Force published in the American Journal of Neuroradiology can also be accessed from this page. Previously, the MRI protocol and guidelines were updated on the CMSC website in 2009. For more information visit: http://www.mscare.org/page/MRI_protocol.
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ABOUT THE CONSORTIUM OF MULTIPLE SCLEROSIS CENTERS (CMSC)
CMSC, the Consortium of Multiple Sclerosis Centers, is the leading educational, training, and networking organization for MS healthcare professionals and researchers. The CMSC mission is to promote high quality MS care through educational programming and accreditation including live and online events, research grants, technical journals and papers, and targeted advocacy efforts. The CMSC member network includes more than 11,000 international healthcare clinicians and scientists committed to MS care as well as more than 60 Veterans Administration MS Programs and 225 MS Centers in the US, Canada, and Europe. The 32nd CMSC Annual Meeting, the largest gathering of MS professionals in North America, will take place May 30-June 2, in Nashville, Tennessee. For more information go to www.mscare.org. Follow CMSC on Twitter: @mscare.org and Facebook: CMSCmscare.
More information:
The 2017 Proposed Revised Guidelines of the CMSC MRI Protocol for the Diagnosis and Follow-up of MS can be found under the “Resources” section on the CMSC website at www.mscare.org.
For more information visit: www.mscare.org or contact Annie Scully, annie.scully@mscare.org
Provided by The Consortium of Multiple Sclerosis Centers